Atypical manifestations of acute hepatitis A virus (HAV) infection include ascites, pleural effusion, acute renal failure, aplastic anemia, and neurological manifestations. Although association of HAV and acute cholecystitis is known, presentation of hepatitis A infection with acute cholecystitis has not been reported in pediatric emergency medicine literature. Primary acute acalculous cholecystitis in children is rare and commonly attributed to systemic infections. We report a case of a child developing acute viral cholecystitis as a presenting feature of sporadic HAV infection and review HAV-associated cholecystitis in children. The article provides a brief illustration of evaluating acute abdominal pain in older children in the emergency department in a developing country.
Transfusion-transmitted malaria (TTM) in neonates is rare. TTM can occur in both endemic and nonendemic areas because the current tests used to screen the donor blood for malaria are unreliable when there is low parasitemia. Malaria must be considered as an important differential diagnosis for neonatal sepsis after exchange transfusion. Management strategy in TTM in the neonatal period is not standardized; exchange transfusion is often considered. We used intravenous artesunate in a case of severe malaria caused by Plasmodium vivax in a 30-week preterm neonate after packed red blood cell transfusion on day 19 of life. This is the first clinical report of parenteral artesunate successfully used in the neonatal period. We emphasize the need for further investigation of the safety and efficacy of intravenous artesunate in the treatment of severe neonatal malaria.
INTRODUCTIONThe Indian population has swollen to 1.21 billion. 1 Children below 5 years constitute 12-15% of this population. In the 1980's the percentage of immunization was less than 5% according to government figures. The campaign picked up in the early 1990's. 2The scenario changed rapidly in the 90's, as the government took up the issue of national immunization. In 1995-96 the immunization was almost 97.1% for BCG, 91.6% for polio, 82.6% for measles. Karnataka too saw such a growth in immunization status. ABSTRACT Background:The Indian population has swollen to 1.21 billion.1 Children below 5 years constitute 12-15% of this population. To determine the immunization status of children <5 years of age attending Tertiary care hospital Outpatient department and the various factors influencing immunization status. Methods: Design of the study was Prospective-descriptive hospital based study. Patients/subjects were one thousand children <5 years of age. Subjects were selected by random sampling method, Immunization status of these children was analyzed and the cause for partial and non-immunization were studied. Information on socio demographic factors and immunization status was analyzed. Results: One thousand children under 5 years were studied for distribution of gender, age, residence, socio-economic status, religion, literacy, type of family, order of birth, type of delivery, number of children, age and occupation of mother. Of all parameters studied there were significant correlation between low maternal education, paternal education , low maternal age (15-20years), agriculture, higher birth order , joint family, low socio-economic, Muslim followed by Hindu, Christian, rural population, age group of 1-5 years, total number of children >2 with partial immunization. Conclusions: We observed that only 32.6% children were fully immunized. Financial problem, Lack of knowledge, immunisation at government hospital, ignorance seems to be a major contributing factors for under immunization. Female gender, rural back ground, belonging to Muslim community, low socioeconomic status, low maternal age, uneducated parents and being from joint family are the other contributing factors for the poor immunization coverage and were found to be statistically significant. Our study shows children had 100% immunised for BCG, OPV-0, OPV-1 and DPT-1.
Background: Children are at higher risk to develop respiratory diseases when they are exposed to biomass smoke. Very few studies have compared the duration of exposure to pulmonary function tests in children. The purpose of the study was to observe the effect of biomass fuel smoke on respiratory symptoms, lung functions in 30 school going children of aged between 7 to 14 years and to compare these parameters with 30 age and sex matched healthy children of same school. And correlate duration of exposure to pulmonary function tests. Methods: This prospective study cross-sectional study was carried out over six months (August 2018 to January 2019). The selection of study population was carried out from one of the Government primary school. 80 students participated in the study. Whole study population was divided in to two groups. Group-1 consisted 40 school children those exposed to biomass smoke aged between 7 to 14 years as cases. Group-2 consisted same number of sex and age matched controls, those had no exposure to biomass smoke. After relevant history, questionnaire and respiratory examinations, children were subjected to spirometry. Schiller’s Spirovit-SP1 was used. Results: The prevalence of some of the respiratory symptoms in biomass smokers were significant compared to non-smokers. There was significant 1.125 fold reduction in FVC (p=0.003*) and 1.195 fold reduction in FEV1 (p=0.000*) in smokers compared to non-smokers. A significant correlation existed between duration of exposure to FVC (r=-0.508 p=0.001) and FEV1 (r=-0.462 p=0.005). Conclusions: We concluded that biomass smoking significantly alters FVC and FEV1 in children and these parameters are negatively correlated with numbers of hours of exposure.
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